Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI

Abstract Assessment of liver function is essential before partial hepatectomy to predict the risk of post hepatectomy liver failure, a severe and life-threatening complication. Traditional methods have focused on expected future liver remnant (FLR) volume estimation. However, liver volume does not a...

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Main Authors: Uffe Kjaergaard, Andrea Lund, Mohsen Redda, Mattias Hedegaard Kristensen, Malene Aastrup, Nikolaj Bøgh, Kim Sivesgaard, Michael A. Ohliger, Daniel B. Vigneron, Lotte Bonde Bertelsen, Aage Kristian Olsen Alstrup, Esben Søvsø Szocska Hansen, Frank Viborg Mortensen, Christoffer Laustsen
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Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-93725-8
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author Uffe Kjaergaard
Andrea Lund
Mohsen Redda
Mattias Hedegaard Kristensen
Malene Aastrup
Nikolaj Bøgh
Kim Sivesgaard
Michael A. Ohliger
Daniel B. Vigneron
Lotte Bonde Bertelsen
Aage Kristian Olsen Alstrup
Esben Søvsø Szocska Hansen
Frank Viborg Mortensen
Christoffer Laustsen
author_facet Uffe Kjaergaard
Andrea Lund
Mohsen Redda
Mattias Hedegaard Kristensen
Malene Aastrup
Nikolaj Bøgh
Kim Sivesgaard
Michael A. Ohliger
Daniel B. Vigneron
Lotte Bonde Bertelsen
Aage Kristian Olsen Alstrup
Esben Søvsø Szocska Hansen
Frank Viborg Mortensen
Christoffer Laustsen
author_sort Uffe Kjaergaard
collection DOAJ
description Abstract Assessment of liver function is essential before partial hepatectomy to predict the risk of post hepatectomy liver failure, a severe and life-threatening complication. Traditional methods have focused on expected future liver remnant (FLR) volume estimation. However, liver volume does not always correlate with function. We suggest that metabolism might be a better surrogate for function than volume. Therefore, we aimed to investigate the metabolic changes in a porcine model of partial portal vein ligation (PVL) using hyperpolarized magnetic resonance imaging (HP-MRI). Specifically, we sought to quantify and compare the pyruvate metabolism in the FLR and the deportalized liver (DL). Six pigs underwent PVL. HP-MRI with [1-13C] pyruvate was performed at baseline, post-surgery, and 1 week after surgery. Metabolic conversion was quantified with kinetic modelling of the rate constants of pyruvate to lactate (kPL) and pyruvate to alanine (kPA). Mean kPL was increased in FLR compared to DL at post-surgery and 1 week after surgery (P = 0.002), while kPA was unaltered (P = 0.761). These findings indicate a metabolic shift towards glycolysis in the FLR. This non-invasive metabolic imaging technique could serve as a powerful tool for evaluation of regional liver function prior to partial hepatectomy and consequently improve patient outcomes.
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spelling doaj-art-2b555c044c854d4ab4793afab7aa84952025-08-20T02:49:32ZengNature PortfolioScientific Reports2045-23222025-03-0115111310.1038/s41598-025-93725-8Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRIUffe Kjaergaard0Andrea Lund1Mohsen Redda2Mattias Hedegaard Kristensen3Malene Aastrup4Nikolaj Bøgh5Kim Sivesgaard6Michael A. Ohliger7Daniel B. Vigneron8Lotte Bonde Bertelsen9Aage Kristian Olsen Alstrup10Esben Søvsø Szocska Hansen11Frank Viborg Mortensen12Christoffer Laustsen13MR Research Centre, Department of Clinical Medicine, Aarhus UniversityDepartment of Surgery, Section for HPB Surgery, Aarhus University HospitalMR Research Centre, Department of Clinical Medicine, Aarhus UniversityMR Research Centre, Department of Clinical Medicine, Aarhus UniversityMR Research Centre, Department of Clinical Medicine, Aarhus UniversityMR Research Centre, Department of Clinical Medicine, Aarhus UniversityDepartment of Radiology, Department of Clinical Medicine, Aarhus University HospitalDepartment of Radiology and Biomedical Imaging, University of CaliforniaDepartment of Radiology and Biomedical Imaging, University of CaliforniaMR Research Centre, Department of Clinical Medicine, Aarhus UniversityDepartment of Nuclear Medicine and PET, Aarhus University HospitalMR Research Centre, Department of Clinical Medicine, Aarhus UniversityDepartment of Surgery, Section for HPB Surgery, Aarhus University HospitalMR Research Centre, Department of Clinical Medicine, Aarhus UniversityAbstract Assessment of liver function is essential before partial hepatectomy to predict the risk of post hepatectomy liver failure, a severe and life-threatening complication. Traditional methods have focused on expected future liver remnant (FLR) volume estimation. However, liver volume does not always correlate with function. We suggest that metabolism might be a better surrogate for function than volume. Therefore, we aimed to investigate the metabolic changes in a porcine model of partial portal vein ligation (PVL) using hyperpolarized magnetic resonance imaging (HP-MRI). Specifically, we sought to quantify and compare the pyruvate metabolism in the FLR and the deportalized liver (DL). Six pigs underwent PVL. HP-MRI with [1-13C] pyruvate was performed at baseline, post-surgery, and 1 week after surgery. Metabolic conversion was quantified with kinetic modelling of the rate constants of pyruvate to lactate (kPL) and pyruvate to alanine (kPA). Mean kPL was increased in FLR compared to DL at post-surgery and 1 week after surgery (P = 0.002), while kPA was unaltered (P = 0.761). These findings indicate a metabolic shift towards glycolysis in the FLR. This non-invasive metabolic imaging technique could serve as a powerful tool for evaluation of regional liver function prior to partial hepatectomy and consequently improve patient outcomes.https://doi.org/10.1038/s41598-025-93725-8Magnetic resonance imagingHyperpolarizedLactate dehydrogenase (LDH)Alanine aminotransferase (ALT)Liver regenerationPortal vein ligation
spellingShingle Uffe Kjaergaard
Andrea Lund
Mohsen Redda
Mattias Hedegaard Kristensen
Malene Aastrup
Nikolaj Bøgh
Kim Sivesgaard
Michael A. Ohliger
Daniel B. Vigneron
Lotte Bonde Bertelsen
Aage Kristian Olsen Alstrup
Esben Søvsø Szocska Hansen
Frank Viborg Mortensen
Christoffer Laustsen
Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
Scientific Reports
Magnetic resonance imaging
Hyperpolarized
Lactate dehydrogenase (LDH)
Alanine aminotransferase (ALT)
Liver regeneration
Portal vein ligation
title Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
title_full Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
title_fullStr Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
title_full_unstemmed Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
title_short Regional quantification of metabolic liver function using hyperpolarized [1-13C] pyruvate MRI
title_sort regional quantification of metabolic liver function using hyperpolarized 1 13c pyruvate mri
topic Magnetic resonance imaging
Hyperpolarized
Lactate dehydrogenase (LDH)
Alanine aminotransferase (ALT)
Liver regeneration
Portal vein ligation
url https://doi.org/10.1038/s41598-025-93725-8
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